What is the role of imaging studies in the workup of dacryocystitis?

Updated: Oct 08, 2019
  • Author: Grant D Gilliland, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

Plain films may be useful in elucidating facial skeletal anomalies or foreign bodies as the cause of the lacrimal disorder. In addition, occasionally, posttraumatic etiologies and mass lesions are noted on plain films as the cause of dacryocystitis.

Echography rarely is used. In most cases, it demonstrates enlargement and engorgement of the lacrimal sac. Rarely, lacrimal sac foreign bodies or masses are noted on echography.

CT scans are useful in patients suspected of harboring an occult malignancy or mass as a cause of dacryocystitis. In addition, posttraumatic causes of dacryocystitis usually are noted with CT scans.

MRIs are not as useful as CT scans but can be helpful in differentiating cystic lesions from solid mass lesions. MRIs can be useful in identifying patients with lacrimal sac diverticuli, which can cause recurrent dacryocystitis without epiphora and failure of surgical correction.

Dacryocystography (DCG) and dacryoscintigraphy are useful adjunctive diagnostic modalities when anatomical abnormalities of the nasolacrimal drainage system are suspected. Subtraction DCG with CT scan is also very sensitive to study the anatomy of the lacrimal sac and surrounding structures.


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